Focus Groups Explore Black Women's Thoughts on Diet and Exercise

Among Black women in the United States, 65.8 percent are overweight or obese.* This raises an important question—what are the factors that influence diet and the level of physical activity among Black women? To explore their knowledge, attitudes, and behaviors, NIDDK’s Weight-control Information Network (WIN) conducted three focus groups with Black women living in Washington, DC, in May 2000.

The groups were made up of eight to 12 women in each of three age ranges: 18 to 30, 31 to 50, and 51 to 60. All participants had incomes of $50,000 or below, and none were employed in the health or medical fields. Each group looked at the women’s perceptions of healthy eating and physical activity, explored their current diet and activity levels, and identified perceived benefits of and barriers to healthy eating and physical activity.

The focus groups provided information that WIN will use in developing materials and activities for its Sisters Together: Move More, Eat Better program. Sisters Together is a media-based program designed to encourage Black women ages 18 and over to maintain a healthy weight by becoming more physically active and eating healthier foods. The program, piloted in Boston from 1995 to 1998, is being expanded nationally.

• Focus groups are designed to provide useful insights into people’s perceptions, attitudes, and motivations. The Washington focus groups provided these insights:
• Many women showed an understanding of nutrition and healthy eating but described their diets as unhealthy. “I eat an unhealthy salad, because I have to put blue cheese dressing all on it...I love it,” said one participant. Another described the difficulty of changing eating habits “if you’ve been used to eating a lot of meat or fat...You’ve been raised with that.”
• When asked about the benefits of healthy eating, younger women mentioned weight control and being able to fit into trendy clothes. Older women were more likely to identify improved health as a benefit.
• Barriers to healthy eating included cost, lack of full service grocery stores in their communities, conven-ience of fast food, confusing food labels, and limited access to fresh produce. “We buy cheap things that will fill our kids,” said one young mother. Another commented that “there’s only so many stores around your neighborhood. Basically, all you have...are greasy fried foods.”
• Body image and cultural norms were also discussed. Some women felt that “being overweight is more accepted [among Blacks]. Black men love thickness.” The younger participants believed that Black women are inherently heavier than White women and should not be encouraged to adopt a “White” standard of beauty. Still, they agreed that most overweight women would prefer to be smaller.
• The women cited weight loss, increased energy and fitness, and self esteem as benefits of physical activity. Yet many said they use their free time to “lay on the sofa and eat and watch TV,” talk on the phone, read, sleep, or “get in the tub and stay there.”
• Barriers to physical activity include pain, fatigue, boredom, lack of child care, lack of an exercise partner, and embarrassment about being seen in athletic wear. Some of the women expressed hair care concerns. One said she would like to swim but she avoids it because “I don’t like fooling with my hair.”
• Women would like to have practical tools to help them shop for and prepare tasty, nutritious meals that are low in price. They mentioned shopping checklists and sample menus to help them “...cook the country or old-fashioned way...geared for African Americans.”

To be effective, health education and promotion efforts must address the needs and interests of their intended audience. These focus groups showed that, even though many Black women are knowledgeable about nutrition and the benefits of physical activity, more culturally specific efforts are needed to encourage Black women to take better care of themselves and their families.

To learn more about Sisters Together: Move More, Eat Better, visit www.niddk.nih.gov/health/nutrit/sisters/sisters.htm. s

* Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, The Evidence Report, NIH Publication No. 98-4083, September 1998: 1.